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津巴布韦新冠疫情对产科瘘修复项目的影响。

Impact of Covid-19 pandemic on obstetric fistula repair program in Zimbabwe.

机构信息

Department of Health Sciences, College of Health, Agriculture and Natural Sciences, Africa University, Mutare, Zimbabwe.

Department of Obstetrics and Gyynaecology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.

出版信息

PLoS One. 2021 Apr 1;16(4):e0249398. doi: 10.1371/journal.pone.0249398. eCollection 2021.

Abstract

The advent of Covid-19 pandemic adversely affected many programs worldwide, public health, including programming for obstetric fistula were not spared. Obstetric fistula is an abnormal connection between the vagina and the bladder or the rectum resulting from obstetric causes, mainly prolonged obstructed labour. Zimbabwe has two obstetric fistula repair centers. Because the program uses specialist surgeons from outside the country, the repairs are organized in quarterly camps with a target to repair 90 women per quarter. This study aimed at assessing the impact of restrictions on movement and gathering of people brought about by the Cocid-19 pandemic and to characterize participants of the camp which was held in the midst of the Covid-19 pandemic at Mashoko Hospital. Specifically it looked at how Covid-19 pandemic affected programming for obstetric fistula repair and characterized participants of the fistula camp held in November to December 2020 at one of the repair centers. A review of the dataset and surgical log sheets for the camp and national obstetric fistula dataset was conducted. Variables of interest were extracted onto an excel spreadsheet and analyzed for frequencies and proportions. Data were presented in charts, tables and narratives. The study noted that Covid-19 pandemic negatively affected performance of fistula repairs greatly with only 25 women repaired in 2020 as compared to 313 in 2019. Ninety women were called to come for repairs but 52 did not manage to attend due to reasons related to the restriction of the Covid-19 pandemic lockdown. Two thirds of those women suffered from urinary incontinence while the other third had fecal incontinence. The successful repair rate was 92%. This study concluded that the pandemic greatly affected programming of fistula repair in the country and recommended the Ministry of Health and Child Care to institute measures to resume programming as soon as the situation allows.

摘要

Covid-19 大流行的出现对全球许多项目产生了不利影响,包括妇产科瘘管病在内的公共卫生项目也未能幸免。产科瘘是由于产科原因导致的阴道与膀胱或直肠之间的异常连接,主要是由于产程延长导致的梗阻。津巴布韦有两个产科瘘修复中心。由于该项目使用来自国外的专科医生,因此修复工作以每季度一次的营地形式组织,目标是每季度修复 90 名妇女。本研究旨在评估因 Covid-19 大流行而导致的人员流动和聚集限制对瘘管病修复计划的影响,并描述在 Covid-19 大流行期间在 Mashoko 医院举行的营地参与者的特征。具体来说,它研究了 Covid-19 大流行如何影响产科瘘修复计划,并描述了 2020 年 11 月至 12 月在其中一个修复中心举行的瘘管病营地的参与者。对营地和国家产科瘘数据集的数据表和手术日志表进行了审查。将感兴趣的变量提取到电子表格中,并进行频率和比例分析。数据以图表、表格和叙述形式呈现。研究注意到,Covid-19 大流行对瘘管修复的影响非常大,2020 年仅修复了 25 名妇女,而 2019 年则修复了 313 名妇女。有 90 名妇女被召集来接受修复,但由于与 Covid-19 大流行封锁相关的限制,有 52 名妇女未能前来。其中三分之二的妇女患有尿失禁,而另外三分之一的妇女患有粪便失禁。修复成功率为 92%。本研究得出结论,大流行对该国的瘘管修复计划产生了重大影响,并建议卫生部和儿童保健部采取措施,一旦情况允许,就恢复该计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59f7/8016295/a0b2c47e50c5/pone.0249398.g001.jpg

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